NPIMap

Organization Active NPI

Independence-Monmouth Family Medicine PC

  • Family Medicine Physician
  • Independence, OR
National Provider Identifier
1598868515
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INDEPENDENCE-MONMOUTH FAMILY MEDICINE PC
Practice address
1430 Monmouth St
Independence, OR 97351
Phone
(503) 838-1133
Fax
(503) 838-5138
NPI assigned
Sep 6, 2006
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Keith Allen White, MDNPI 1407959422
Title
Official Representative
Phone
(503) 838-1133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1430 Monmouth St
Independence, OR 97351

Mailing address

PO Box 309
Independence, OR 97351
Phone (503) 838-1133

Other identifiers 1

IdentifierTypeStateIssuer
269340MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1598868515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "INDEPENDENCE",
            "state": "OR",
            "postal_code": "97351",
            "telephone_number": "503-838-1133",
            "fax_number": "503-838-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 MONMOUTH ST",
            "city": "INDEPENDENCE",
            "state": "OR",
            "postal_code": "97351",
            "telephone_number": "503-838-1133",
            "fax_number": "503-838-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE-MONMOUTH FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OFFICIAL REPRESENTATIVE",
        "authorized_official_telephone_number": "503-838-1133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269340",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.